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ABG's & Compensation
ABG's & Compensation
20
Health Care
02/01/2010

Additional Health Care Flashcards

 


 

Cards

Term
Arterial Blood Gases
Definition

pH = measures acid-base

 

PaCO2 = partial pressure of CO2 in the blood, affected by CO2 removal in the lungs

 

HCO3 = measure the bicarbonate content of the blood; affected by renal production of bicarbonate

Term

Normal ABG Ranges

Definition
  • pH = 7.35 - 7.45
    • pH < 7.35 = acidosis
    • pH > 7.45 = alkalosis

  • PaCO2 = 35 - 45
    • PaCO2 < 35 = alkalosis
    • PaCO2 > 45 = acidosis
  • HCO3 =22 - 26
    • HCO3 < 22 = acidosis
    • HCO3 > 26 = alkalosis
  • PaO2 =80 - 100
Term
Clinical Manifestations of Acidosis
Definition
  • CNS:
    • depressed acitivty, lethargy, confusion, stupor, coma
  • Neuromuscular:
    • hyporeflexia, skeletal muscle weakness, flaccid paralysis
  • Cardio:
    • delayed electrical conduction
    • bradycardia to heart block
    • Hypotension, thready peripheral pulses
  • Respiratory:
    • Kussmaul respirations
  • Skin:
  • warm, flushed, dry skin (metabolic acidosis)
  • pale - cyanotic, dry skin (respiratory acidosis)
Term

Causes of Respiratory Acidosis

 

pH & PaCO2

 

HCO3 normal

 

Definition

anesthesia

drug overdose

COPD

pneumonia

head & neck trauma

muscle weakness

airway obstruction

electrolyte imbalance

inadequate chest expansion

 

Term

Signs & Symptoms of Respiratory Acidosis

 

pH & PaCO2

 

HCO3 normal

Definition

hypoventilation → hypoxia

rapid, shallow respirations

↓ BP w/ vasodilation

dyspnea

headache

hyperkalemia

Dysrhythmias (↑ K+)

drowsiness / dizziness / disorientation

muscle weakness

hyperreflexia

Term

Treatment of Respiratory Acidosis

 

pH & PaCO2

 

HCO3 normal

Definition

maintain patent airway

enhance gas exchange

oxygen therapy

bronchodilators

 

Term

Causes of Metabolic Acidosis

 

pH & HCO3

 

PaCO2 normal

Definition

diarrhea - loss of HCO3

DKA

renal failure

shock

hypermetabolism

Term

Signs & Symptoms of Metabolic Acidosis

 

pH & HCO3

 

PaCO2 normal

Definition

headache

decreased BP

hyperkalemia

muscle twitching

warm, flushed skin

nausea / vomiting / diarrhea

Changes in LOC: confusion, increased drowsiness

Kussmaul respirations

Term

Treatment of Metabolic Acidosis

 

pH & HCO3

 

PaCO2 normal

Definition

Diarrhea = IV fluids, anti-diarrheals

 

DKA = insulin & IV fluids

 

Renal failure = dialysis

Term

Causes for Respiratory Alkalosis

 

pH ↑ & PaCO2

 

HCO3 normal

Definition

Too much CO2 being exreted by the lungs

 

Hyperventilation

Fear

Anxiety

mechanical ventilation

 

Hypoxemia

high altitudes

shock

 

Term

Signs & Symptoms of Respiratory Alkalosis

 

pH ↑ & PaCO2

 

HCO3 normal

Definition

seizures

Kussamaul respirations

hyperventilation

tachycardia

low or Normal BP

hypokalemia

numbness/ tingling of extremeties

lethargy & confusion

light headedness

nausea / vomiting

Term

Causes of Metabolic Alkalosis

 

pH & HCO3

 

PaCO2 normal

Definition

Loss of acid

increase in HCO3

severe vomiting

excessive NG drainage / GI suctioning

thiazide diuretics

excessive use fo antacids

excessive Na+HCO3

Parenteral base administration: blood transfusions, TPN

Hyperaldosteronism

Term

Signs & Symptoms of Metabolic Alkalosis

 

pH & HCO3

 

PaCO2 normal

Definition

nausea / vomiting/ diarrhea

tremors / muscle cramps

tingling of fingers & toes

hypokalemia

restlessness then lethargy

dyrhythmia - tachycardia

compensatory hypoventilation

confusion / decreased LOC / dizzy / irritable

Term
Clinical Manifestations of Alkalosis
Definition
  • CNS:
    • increased acitivty
    • anxiety & irritability
    • tetany
    • seizures
    • Positive Chvostek's sign &  Trousseau's sign
    • paresthesia
  • Neuromuscular:
    • hyperreflexia
    • muscle cramping & twitching
    • skeletal muscle weakness
  • Cardio:
    • increased HR
    • normal or low BP
    • Respiratory:
    • increased rate & depth w/ respiratory alkalosis
    • decreased effort w/ metabolic alkalosis
Term

Partial Compensation

 

Definition
  • If you're seeing a pH outside the normal range, your disorder is either uncompensated or partially compensated.


  • Partial compensation prevents the acid-base imbalance from becoming severe or life threatening


  • Respiratory compensation occurs through the lungs, usually to correct for acid-base imbalances from metabolic problems.

 

Term
Renal compensation
Definition

 

  • Renal compensation results when a healthy kidney works to correct changes in the blood pH that occur when the respiratory system is overwhelmed or not healthy


  • Renal compensatory mechanisms are much more powerful than respiratory but are not as rapid


  • Renal compensation are not fully triggered unless the acid-base imbalance continues for several hours to several days

 

Term

What is it??

 

 

pH

7.25

¯ pH

Acidosis

PaCO2

50

­ PaCO2

Acidosis

HCO3

27

­ HCO3

Alkalosis

Definition

 

  • Partially compensated respiratory acidosis
    • pH & PaCO2 match – respiratory
    • HCO3 odd one out
    • pH is not normal so only partially compensated

 

Term

What is it???

 

 

 

pH

7.48

­ pH

Alkalosis

PaCO2

46

­ PaCO2

Acidosis

HCO3

30

­ HCO3

Alkalosis

Definition

ANSWER:

 

 

  • Partially compensated metabolic alkalosis
    • pH & HCO3 match – metabolic
    • PaCO2 odd one out
    • pH is not normal so only partially compensated

 

Term

What is it??

 

 

pH

7.45

N pH

High Normal

PaCO2

46

­ PaCO2

Acidosis

HCO3

32

­ HCO3

Alkalosis

Definition

ANSWER:

 

 

  • Fully compensated metabolic alkalosis
    • Even though pH is normal it s high normal which would be alkalosis
    • If pH were alkalosis then HCO3 would match – metabolic
    • pH is normal so fully compensated

 

Term

What is it??

 

 

pH

7.35

N pH

Low Normal

PaCO2

50

­ PaCO2

Acidosis

HCO3

27

­ HCO3

Alkalosis

Definition

ANSWER:

 

  • Fully compensated respiratory acidosis
    • Even though pH is normal its low normal which would be acidosis
    • If pH were acidosis then PaCO2 would match – respiratory
    • pH is normal so fully compensated